Department of Health

Charges for durable medical equipment are often included in the comprehensive Medicaid reimbursement rates for nursing homes. Accordingly, Medicaid generally should not be billed separately for these charges when such equipment is provided to nursing home residents. However, in audit 2007-S-18, we found that Medicaid sometimes was billed separately for this equipment. During our five-year audit period, we identified about $3.1 million in potentially inappropriate payments for such equipment. We recommended that the payments be investigated, all inappropriate payments recovered, and controls improved to prevent such payments in the future. When we followed up on these matters with Department of Health officials, we found that they had generally implemented our audit recommendations.

For a complete copy of Report 2009-F-12 click here.
For a copy of the 90-day response click here.